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General NPI Number Information
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NPI Number | 1649424599
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Entity Type | Organization
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Legal Business Name | ATLANTA CARDIO-PULMONARY RESEARCH CLINIC
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 1100 JOHNSON FERRY RD NE BLDG II SUITE 165
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City | ATLANTA
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State | GA
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Zip | 30342-1709
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Country | US
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Telephone | 404-966-3775
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Fax |
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Provider Business Mailing Address
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Address Line | 7300 CHATTAHOOCHEE BLUFF DR
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City | ATLANTA
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State | GA
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Zip | 30350-1072
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Country | US
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Telephone | 404-966-3775
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. NICOLE SULLIVAN MASLANKA
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Credential | B.S.N., M.A., A.B.D.
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Telephone | 404-966-3775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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